NR 452 CAPSTONE NURSING EXAM-COMPLETE
QUESTIONS AND ANSWERS PLUS DETAILED
RATIONALES | NEWEST STUDYGUIDE | DOWNLOAD
INSTANT PDF 2027-2028
1. A nurse is caring for a client who is post-operative day one following an abdominal
hysterectomy. The client reports severe lower abdominal pain rating 8 out of 10. Which
action should the nurse take first?
A. Administer the prescribed intravenous opioid analgesic.
B. Assess the client’s surgical incision and vital signs.
C. Assist the client to ambulate in the hallway.
D. Apply a warm compress to the client’s lower abdomen.
Answer: B
Assessment is the first step of the nursing process and must be performed before implementing
interventions. Assessing vital signs and the incision site allows the nurse to rule out acute
surgical complications, such as internal hemorrhage or infection, before administering pain
medication or attempting non-pharmacological comfort measures.
2. A public health nurse is preparing an educational presentation on primary prevention
strategies for community members. Which topic should the nurse include?
A. Routine mammography screening for women over age 40.
B. Administering influenza vaccinations at a community clinic.
C. Cardiac rehabilitation programs for post-myocardial infarction clients.
D. Fasting blood glucose testing for early diabetes detection.
Answer: B
Primary prevention focuses on health promotion and disease prevention prior to the
occurrence of illness. Immunizations, such as the influenza vaccine, are classic examples of
primary prevention. Screenings (mammograms, glucose tests) represent secondary prevention,
while rehabilitation programs represent tertiary prevention.
,3. A nurse on a medical-surgical unit receives a change-of-shift report for four clients.
Which client should the nurse assess first?
A. A client with chronic obstructive pulmonary disease (COPD) having an oxygen saturation of
89% on 2 L/min nasal cannula.
B. A client with type 1 diabetes mellitus reporting a blood glucose level of 60 mg/dL and
lightheadedness.
C. A client who is two days post-cholecystectomy requesting assistance to use the bedside
commode.
D. A client receiving intravenous antibiotics who reports mild localized itching at the infusion
site.
Answer: B
Hypoglycemia (blood glucose below 70 mg/dL) presents an immediate risk for neurological
decline and altered mental status, making this client the highest priority using the ABC and
acute vs. chronic framework. An oxygen saturation of 89% is expected for chronic COPD,
whereas hypoglycemia requires immediate swift administration of fast-acting carbohydrates.
4. A nurse manager is observing a staff nurse perform hand hygiene. Which action by the
staff nurse demonstrates correct infection control technique?
A. Washing hands with non-antimicrobial soap for at least 5 seconds.
B. Using alcohol-based hand rub after caring for a client with Clostridioides difficile.
C. Drying hands thoroughly from fingers to wrists with a clean paper towel.
D. Turning off the water faucet directly with clean, bare hands after washing.
Answer: C
Hands should be dried from the cleanest area (fingers) to the least clean area (wrists) to
prevent recontamination. Clostridioides difficile spores are resistant to alcohol-based rubs and
require soap and water washing for at least 20 seconds. Faucets must be turned off using a
clean paper towel.
5. A home health nurse is conducting an initial assessment on an older adult client who
lives alone. Which finding is the clearest indicator of potential elder self-neglect?
A. The presence of expired canned foods stored in the kitchen pantry.
B. Minor skin bruising observed on the client's forearms.
,C. Unpaid utility bills and an absence of adequate heat in the home.
D. A client refusal to participate in daily physical therapy exercises.
Answer: C
Self-neglect involves an inability to provide for one's own basic needs, including safety,
shelter, utilities, nutrition, and hygiene. Lacking basic utilities like heating in a residential
dwelling poses immediate health risks, serving as a primary operational red flag for self-
neglect requiring interprofessional intervention.
6. A staff nurse notes that a unit physician consistently writes illegible prescription orders.
What is the most appropriate action by the nurse?
A. Transcribe the order based on clinical experience and knowledge of the client.
B. Ask another experienced nurse on the unit to decipher the handwriting.
C. Contact the prescribing physician directly to clarify the illegible order.
D. Report the physician immediately to the hospital ethics committee.
Answer: C
Client safety dictates that any unclear, incomplete, or illegible prescription must be clarified
directly with the prescriber prior to execution. Guessing or relying on peer consensus
introduces severe medication error risks and violates professional standards of care.
7. A nurse is caring for a client who underwent a left total hip arthroplasty six hours ago.
Which positioning instruction should the nurse implement?
A. Adduct the left leg across the midline of the body.
B. Maintain the left leg in an abducted position using a pillow.
C. Flex the left hip past 90 degrees when seated.
D. Place the client in a prone position every four hours.
Answer: B
Abduction prevents joint dislocation following a total hip arthroplasty. Using an abduction
pillow keeps the operative extremity away from the midline, maintaining proper alignment of
the hip prosthesis during the acute post-operative phase. Crossing legs (adduction) or flexing
hips past 90 degrees increases dislocation risk.
, 8. A pediatric nurse is evaluating a 4-year-old child during a routine wellness visit. Which
developmental milestone should the nurse expect the child to have achieved?
A. Hopping on one foot and cutting shapes with scissors.
B. Tying shoes independently with a double knot.
C. Printing full sentences with correct punctuation.
D. Riding a two-wheeled bicycle without training wheels.
Answer: A
By age 4, children typically demonstrate gross motor skills like hopping on one foot and fine
motor skills like using scissors to cut simple shapes. Tying shoes and riding a two-wheeled
bicycle are typical for ages 5 to 6, while writing full sentences occurs later in primary school.
9. A nurse is reviewing lab results for a client receiving intravenous furosemide. Which
electrolyte imbalance should the nurse monitor for most closely?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypernatremia
Answer: B
Furosemide is a loop diuretic that causes the excretion of water, sodium, chloride, and
potassium. Potassium loss (hypokalemia) is a major adverse effect that can trigger cardiac
dysrhythmias and muscle weakness, requiring vigilant serum potassium monitoring.
10. A clinical nurse educator is conducting a training session on legal documentation
standards. Which entry in the client's medical record represents correct documentation
practice?
A. "Client appears to be manipulative and seeking attention today."
B. "Administered 5 mg morphine IV at 0900 for reported pain level of 7/10."
C. "Doctor was informed about bad lab results earlier this morning."
D. "Client had an uneventful night shift with no major issues."
QUESTIONS AND ANSWERS PLUS DETAILED
RATIONALES | NEWEST STUDYGUIDE | DOWNLOAD
INSTANT PDF 2027-2028
1. A nurse is caring for a client who is post-operative day one following an abdominal
hysterectomy. The client reports severe lower abdominal pain rating 8 out of 10. Which
action should the nurse take first?
A. Administer the prescribed intravenous opioid analgesic.
B. Assess the client’s surgical incision and vital signs.
C. Assist the client to ambulate in the hallway.
D. Apply a warm compress to the client’s lower abdomen.
Answer: B
Assessment is the first step of the nursing process and must be performed before implementing
interventions. Assessing vital signs and the incision site allows the nurse to rule out acute
surgical complications, such as internal hemorrhage or infection, before administering pain
medication or attempting non-pharmacological comfort measures.
2. A public health nurse is preparing an educational presentation on primary prevention
strategies for community members. Which topic should the nurse include?
A. Routine mammography screening for women over age 40.
B. Administering influenza vaccinations at a community clinic.
C. Cardiac rehabilitation programs for post-myocardial infarction clients.
D. Fasting blood glucose testing for early diabetes detection.
Answer: B
Primary prevention focuses on health promotion and disease prevention prior to the
occurrence of illness. Immunizations, such as the influenza vaccine, are classic examples of
primary prevention. Screenings (mammograms, glucose tests) represent secondary prevention,
while rehabilitation programs represent tertiary prevention.
,3. A nurse on a medical-surgical unit receives a change-of-shift report for four clients.
Which client should the nurse assess first?
A. A client with chronic obstructive pulmonary disease (COPD) having an oxygen saturation of
89% on 2 L/min nasal cannula.
B. A client with type 1 diabetes mellitus reporting a blood glucose level of 60 mg/dL and
lightheadedness.
C. A client who is two days post-cholecystectomy requesting assistance to use the bedside
commode.
D. A client receiving intravenous antibiotics who reports mild localized itching at the infusion
site.
Answer: B
Hypoglycemia (blood glucose below 70 mg/dL) presents an immediate risk for neurological
decline and altered mental status, making this client the highest priority using the ABC and
acute vs. chronic framework. An oxygen saturation of 89% is expected for chronic COPD,
whereas hypoglycemia requires immediate swift administration of fast-acting carbohydrates.
4. A nurse manager is observing a staff nurse perform hand hygiene. Which action by the
staff nurse demonstrates correct infection control technique?
A. Washing hands with non-antimicrobial soap for at least 5 seconds.
B. Using alcohol-based hand rub after caring for a client with Clostridioides difficile.
C. Drying hands thoroughly from fingers to wrists with a clean paper towel.
D. Turning off the water faucet directly with clean, bare hands after washing.
Answer: C
Hands should be dried from the cleanest area (fingers) to the least clean area (wrists) to
prevent recontamination. Clostridioides difficile spores are resistant to alcohol-based rubs and
require soap and water washing for at least 20 seconds. Faucets must be turned off using a
clean paper towel.
5. A home health nurse is conducting an initial assessment on an older adult client who
lives alone. Which finding is the clearest indicator of potential elder self-neglect?
A. The presence of expired canned foods stored in the kitchen pantry.
B. Minor skin bruising observed on the client's forearms.
,C. Unpaid utility bills and an absence of adequate heat in the home.
D. A client refusal to participate in daily physical therapy exercises.
Answer: C
Self-neglect involves an inability to provide for one's own basic needs, including safety,
shelter, utilities, nutrition, and hygiene. Lacking basic utilities like heating in a residential
dwelling poses immediate health risks, serving as a primary operational red flag for self-
neglect requiring interprofessional intervention.
6. A staff nurse notes that a unit physician consistently writes illegible prescription orders.
What is the most appropriate action by the nurse?
A. Transcribe the order based on clinical experience and knowledge of the client.
B. Ask another experienced nurse on the unit to decipher the handwriting.
C. Contact the prescribing physician directly to clarify the illegible order.
D. Report the physician immediately to the hospital ethics committee.
Answer: C
Client safety dictates that any unclear, incomplete, or illegible prescription must be clarified
directly with the prescriber prior to execution. Guessing or relying on peer consensus
introduces severe medication error risks and violates professional standards of care.
7. A nurse is caring for a client who underwent a left total hip arthroplasty six hours ago.
Which positioning instruction should the nurse implement?
A. Adduct the left leg across the midline of the body.
B. Maintain the left leg in an abducted position using a pillow.
C. Flex the left hip past 90 degrees when seated.
D. Place the client in a prone position every four hours.
Answer: B
Abduction prevents joint dislocation following a total hip arthroplasty. Using an abduction
pillow keeps the operative extremity away from the midline, maintaining proper alignment of
the hip prosthesis during the acute post-operative phase. Crossing legs (adduction) or flexing
hips past 90 degrees increases dislocation risk.
, 8. A pediatric nurse is evaluating a 4-year-old child during a routine wellness visit. Which
developmental milestone should the nurse expect the child to have achieved?
A. Hopping on one foot and cutting shapes with scissors.
B. Tying shoes independently with a double knot.
C. Printing full sentences with correct punctuation.
D. Riding a two-wheeled bicycle without training wheels.
Answer: A
By age 4, children typically demonstrate gross motor skills like hopping on one foot and fine
motor skills like using scissors to cut simple shapes. Tying shoes and riding a two-wheeled
bicycle are typical for ages 5 to 6, while writing full sentences occurs later in primary school.
9. A nurse is reviewing lab results for a client receiving intravenous furosemide. Which
electrolyte imbalance should the nurse monitor for most closely?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypernatremia
Answer: B
Furosemide is a loop diuretic that causes the excretion of water, sodium, chloride, and
potassium. Potassium loss (hypokalemia) is a major adverse effect that can trigger cardiac
dysrhythmias and muscle weakness, requiring vigilant serum potassium monitoring.
10. A clinical nurse educator is conducting a training session on legal documentation
standards. Which entry in the client's medical record represents correct documentation
practice?
A. "Client appears to be manipulative and seeking attention today."
B. "Administered 5 mg morphine IV at 0900 for reported pain level of 7/10."
C. "Doctor was informed about bad lab results earlier this morning."
D. "Client had an uneventful night shift with no major issues."
